Room Surfaces Research Articles

The effect of PDCA cycle combined with SOP applied in periodic cleaning of object surfaces in the clean operating room

Objective To explore the application effect of PDCA cycle combined with standardized operation procedure in periodic cleaning of objects surfaces of clean operating room, so as to provide reference for management and control of surgical infection. Methods PDCA cycle was applied to analyze the periodic cleaning conditions of 336 surgical rooms in the operating room from July to December 2016.The results showed that the clearance rate of surface fluorescence labeling was 75.30%, the average time of periodic cleaning was 3.5 hours per operation room, the ratio of periodic cleaning personnel to room was 57.14%, the average defect rate of surface cleaning was 37.80%, the quality control rate was 27.38%, etc.Improvement measures were formulated: the cleaning table of periodic objects between clean operations was formulated to clarify the contents of periodic cleaning, and standardized operation procedure manual and video were developed accordingly for the training of general practitioners, and the responsibility was transferred to people.Comparison was made between January and June 2017 after the intervention. Results Compared with before intervention, the clearance rate of fluorescent label monitoring on the interoperative table was increased to 93.75%, the average time of periodic cleaning was reduced to 2.2 hours, the room ratio of periodic cleaning personnel was 28.57%, the defect rate of surface cleaning was 3.2%, and the quality control rate was 7.8%. All the differences were statistically significant (P<0.05). Conclusion PDCA cycle combined with standardized operation procedure can significantly improve the qualified rate of periodic cleaning of the surface of the clean operating room.It can reduce the defect rate of surface cleaning, shorten the cleaning time, reduce labor cost, improve work efficiency, enhance the quality of infection control in operating room, and it is worth popularizing and applying in clinic. Key words: Plan-Do-Check-Action; Standardized operation procedure; Operating room; Object surfaces clean; Infection control

Use of Ultraviolet Irradiation in Addition to Commonly Used Hospital Disinfectants or Cleaners Further Reduces the Bioburden on High-Touch Surfaces.

The reduction in microbial bioburden achieved by terminal disinfection in a hospital may vary considerably by type of disinfectant or cleaner and by environmental service (EVS) personnel. This study estimated whether supplemental ultraviolet (UV) irradiation after disinfection or cleaning reduced bioburden and whether the supplemental effect persisted after adjusting for disinfectant or cleaner type and EVS personnel. Environmental samples for aerobic bacterial colonies (ABC) and methicillin-resistant Staphylococcus aureus (MRSA) were obtained from 5 high-touch surfaces in patient rooms at 3 time points: before manual cleaning, after manual cleaning using 1 of 3 disinfectants or 1 cleaner, and after UV irradiation. For ABC, the model-estimated mean (95% uncertainty interval) counts were 56% (48%-63%) lower for postmanual + UV compared with manual clean alone, and for MRSA they were 93% (62%-99%) lower for postmanual + UV vs manual clean alone. Although UV supplementation provides incremental benefit in bioburden reduction across all cleaners or disinfectants tested, it provides the greatest benefit when supplementing cleaners or disinfectants with the lowest disinfection properties. UV irradiation provides additional bioburden reduction to manual cleaning or disinfection, even when accounting for variability introduced by different disinfectants and EVS personnel.

Factors influencing scattering coefficient measurement accuracy in scaled reverberation room

The method described in ISO 17497-1 standard has been worldwide adopted to measure the random-incident scattering coefficient of irregular surfaces either in a full-size reverberation room or in a scale model. In practical measurements, the sound energy propagation and decay at high frequencies (over 10 kHz) are easily affected by small operating errors and by tiny changes in the measurement conditions. It is difficult to obtain the same accuracy of results in the scale model as that in a full-size reverberation room while maintaining the same setup in both tests as suggested in the standard. This study performed a series of experiments in a 1:10 scale reverberation room to investigate the influence of several practical aspects on measurement accuracy. A maximum length sequence diffuser, with a design frequency of 1700 Hz (full-size value), was used as the specimen. All results obtained in the scaled reverberation room were compared to the reference values measured in a full-size reverberation room. Five factors were studied, which included different recording methods (double-channel and eight-channel), number of source positions (one and four), number of receiver positions (one, two, four and eight), turntable rotation conditions (full-turn or half-turn rotation during T3 and T4 measurements), and numbers of averages (24, 36 and 72). The results show that the first three factors above have greater impacts on the measurement accuracy of the scale model experiments than the remaining factors. When the multichannel recording method and four source positions were used in the scaled tests, the measured scattering coefficient values were more reliable, appearing much closer to the reference data over the whole frequency range. Furthermore, applying a half-turn of the turntable (in reference to the measurements of the axisymmetric diffusers) and a 36-impulse coherent average can greatly reduce the test duration without decreasing the measurement accuracy.

Infection Risk Reduction Program on Pathogens in High School and Collegiate Athletic Training Rooms.

Background:Athletic training rooms have a high prevalence of bacteria, including multidrug-resistant organisms, increasing the risk for both local and systematic infections in athletes. There are limited data outlining formal protocols or standardized programs to reduce bacterial and viral burden in training rooms as a means of decreasing infection rate at the collegiate and high school levels.Hypothesis:Adaptation of a hygiene protocol would lead to a reduction in bacterial and viral pathogen counts in athletic training rooms.Study Design:Cohort study.Level of Evidence:Level 3.Methods:Two high school and 2 collegiate athletic training rooms were studied over the course of the 2017-2018 academic year. A 3-phase protocol, including introduction of disinfectant products followed by student-athlete and athletic trainer education, was implemented at the 4 schools. Multiple surfaces in the athletic training rooms were swabbed at 4 time points throughout the investigation. Bacterial and viral burden from swabs were analyzed for overall bacterial aerobic plate count (APC), bacterial adenosine triphosphate activity, influenza viral load, and multidrug-resistant organisms such as methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococcus (VRE).Results:Overall bacterial load, as measured by APC, was reduced by 94.7% (95% CI, 72.6-99.0; P = 0.003) over the course of the investigation after protocol implementation. MRSA and VRE were found on 24% of surfaces prior to intervention and were reduced to 0% by the end of the study. Influenza was initially detected on 25% of surfaces, with no detection after intervention. No cases of athletic training room–acquired infections were reported during the study period.Conclusion:A uniform infection control protocol was effective in reducing bacterial and viral burden, including multidrug-resistant organisms, when implemented in the athletic training rooms of 2 high schools and 2 colleges.Clinical Relevance:A standardized infection control protocol can be utilized in athletic training rooms to reduce bacterial and viral burden.

Environmental Contamination with Candida Species in Multiple Hospitals Including a Tertiary Care Hospital with a Candida auris Outbreak.

Background:Environmental sources have been implicated as a potential source for exogenous acquisition of Candida species, particularly the emerging multidrug-resistant Candida auris. However, limited information is available on environmental reservoirs of Candida species in healthcare facilities.Methods:During a 6-month period, cultures for Candida species were collected from high-touch surfaces in patient rooms and from portable equipment in 6 US acute care hospitals in 4 states. Additional cultures were collected from sink drains and floors in one of the hospitals and from high-touch surfaces, portable equipment, and sink drains in a hospital experiencing an outbreak due to C. auris. Candida species were identified using matrix-assisted laser desorption/ionization time-of-flight mass spectometry.Results:Candida species were recovered from patient rooms in 4 of the 6 hospitals. Seven of 147 patient room cultures (4.8%) and 1 of 57 (1.8%) portable equipment cultures were positive, with the most common species being C. parapsilosis. For the hospital where additional sites were sampled, Candida species were recovered from 8 of 22 (36.4%) hospital room floors and 4 of 17 (23.5%) sink drains. In the facility with a C. auris outbreak, Candida species were frequently recovered from sink drains (20.7%) and high-touch surfaces (15.4%), but recovery of C. auris was uncommon (3.8% of high-touch surfaces, 3.4% of sink drains, and 0% of portable equipment) and only present in rooms that currently or recently housed a patient with C. auris.Conclusion:Candida species often contaminate surfaces in hospitals and may be particularly common on floors and in sink drains. However, C. auris contamination was uncommon in a facility experiencing an outbreak, suggesting that current cleaning and disinfection practices can be effective in minimizing environmental contamination.

511. MDRO Carriage in Patients in Two ICUs and Prevalence of Environmental Surface and Healthcare Worker Hand Contamination

BackgroundDetermining MDRO (multidrug-resistant organism) transmission routes in intensive care units (ICUs) can be complex and require the evaluation of multiple potential MDRO sources, including patients, the environment, and healthcare worker (HCW) hands. The objective of this study was to determine MDRO carriage in patients in two separate ICUs, and simultaneous environmental and HCW hand contamination from associated rooms.MethodsPatient (P), environmental (E), and HCW hand (H) samples were collected from hospital A (1183 H, 1253 E, 729 P) and hospital B (699 H, 1372 E, 437 P) over approximately 5 weeks in each unit. Environmental and HCW hand samples were collected using a cellulose sponge. HCW hand samples were collected prior to any hand hygiene. Patient samples were collected from the axilla, groin, and perianal areas with a flocked swab with patient consent. All samples were tested semi-quantitatively for Clostridium difficile (Cdiff), vancomycin-resistant enterococci (VRE), and cefotaxime-resistant Enterobacteriaceae (Cef-R-Ent) by selective culture. Cdiff isolates representative of each P/E/H cluster were tested for Cdiff toxin testing by PCR.ResultsCdiff, VRE, and Cef-R-Ent were detected in patients, patient rooms, and on HCW hands in both facilities (Table 1). Cdiff was more prevalent in Facility A, while Cef-R-Ent was more prevalent in Facility B. The prevalence of VRE was minimal in both facilities. Cdiff toxin gene testing revealed that 17% of the Cdiff isolate clusters tested positive for toxin genes. In Facility A, the prevalence of a given MDRO was similar regardless of sample type, but was more widely varied between sample types in Facility B. Prevalence of MDROs on HCW hands and in the environment was typically higher in Facility A compared with Facility B. Individual patient positives were frequently linked to positive HCW hand and environmental cultures.ConclusionWe discovered a low prevalence of all MDROs in both facilities, with most positive cultures associated with patients who were not on MDRO precautions. HCW hand and environmental MDRO prevalence was generally similar for each MDRO, regardless of patient prevalence, supporting previously reported links on HCW hand contamination and hospital room surfaces. Disclosures All authors: No reported disclosures.

Effect of pulsed xenon ultraviolet disinfection on methicillin-resistant Staphylococcus aureus contamination of high-touch surfaces in a Japanese hospital

The hospital environment is an important source of multidrug-resistant organisms such as methicillin-resistant Staphylococcus aureus (MRSA). Here, we evaluated the efficacy of pulsed xenon ultraviolet (PX-UV) disinfection in addition to manual cleaning in a Japanese hospital. Environmental samples were collected from inpatient rooms that had been occupied for at least 48 hours by patients infected or colonized with MRSA. High-touch surfaces from 11 rooms were sampled before and after manual cleaning and then after PX-UV disinfection. Changes in bacterial counts and in the number of aerobic bacteria (AB)- and MRSA-positive samples between sampling points were assessed. The time taken to complete PX-UV treatment of patient rooms was also recorded. A total of 306 samples were collected. PX-UV disinfection resulted in a significant decrease in abundance of AB and MRSA (mean colony-forming units 14.4 ± 38.7 to 1.7 ± 6.1, P < .001 and 1.1 ± 3.9 to 0.3 ± 2.0, P < .001, respectively) and in the number of AB- and MRSA-positive samples (58.8%-28.4%, P = .001 and 19.6%-3.9%, P < .001, respectively) compared with manual cleaning. The median time of in-room use of the PX-UV device was 20 minutes. The addition of PX-UV disinfection to the manual cleaning process significantly reduced AB and MRSA contamination of high-touch surfaces in hospital inpatient rooms.

Flow resistivity estimation from practical absorption coefficients of fibrous absorbers

There are useful conversion methods from Sabine absorption coefficients according to ISO 354 to other acoustic properties for room boundaries, e.g., surface impedance or flow resistivity. However, most available sound absorption coefficients are practical absorption coefficients, which are simplified according to ISO 11654 from the Sabine absorption coefficients and widely used by absorber manufacturers as their absorbers’ performance indicators. In this study, practical absorption coefficients are used to inversely characterize the flow resistivity via reliable models. 15 absorber samples with varying mounting conditions are used for validating the flow resistivity estimation, having a wide flow resistivity range of 10–110 kNsm−4. As expected, the practical absorption coefficients are found to be less reliable input parameters for estimating the flow resistivity, but with more datasets, the degradation becomes insignificant compared to the Sabine absorption coefficients. The estimated flow resistivity will be a valuable parameter to predict the absorption characteristics of different thickness and mounting conditions.

Suitability Assessment and Experimental Characterization of Phase Change Materials for Energy Conservation in Indian Buildings

Abstract With increasing energy consumption in buildings, energy efficiency measures are matter of prime concern. A huge portion of energy consumed in buildings is used for regulating the thermal comfort. A solution to this is to incorporate phase change material (PCM) within the building elements which increases their overall thermal capacity. In the present study, the temperature of inner room surface, with and without PCM incorporation, is calculated for composite climate of Delhi. The analysis of PCM sandwiched walls has been performed. The performance analysis of five PCMs, having different melting temperatures, is carried out with nodal temperatures as the output. The results show that a phase change temperature range of 34–38 °C is suitable for peak summer conditions of Delhi. It is also observed that due to the low thermal conductivity of PCMs, they act as both storage medium and insulation, thus reducing temperature fluctuation during summer/winter. Based on the simulation, three PCMs were found suitable and hence were experimentally tested for their characteristic charging and discharging properties and performance, using differential scanning calorimeter (DSC). Based on the characterization results, it is concluded that two commercially available PCMs (Eicosane and OM35) are suitable for Delhi. All the other PCMs have also been simulated for different climatic conditions in India and their impact on heat gain has been assessed.

Development of empirical models to predict cooling performance of a thermoelectric radiant panel

Performance simulations of thermoelectric radiant panels (TERPs) provide valuable information for the use of TERPs as alternatives to conventional hydraulic radiant panels, which require refrigerants based on the vapor compression cycle. Several existing models are appropriate for the design of the TERP; however, there are limitations to the building simulation with respect to the evaluation of the annual energy performance because existing models for TERP are based on the numerical method, therefore it is very complex to integrate with the building model. To overcome these limitations, simplified empirical models should be developed based on experimental data and then verified.This study aims to develop two simplified prediction models for the cooling capacity and energy consumption of TERPs. Using the 2k factorial experiment design method, a total of 16 experiment sets were designed according to the four main operation parameters: room temperature, outdoor air temperature, face velocity of air in duct, and combined heat transfer coefficient between room and panel surface. The developed models were designed in dimensionless forms to ensure broad applicability. The developed models yielded good R2 values exceeding 0.99 and were validated under additional operation conditions. Finally, the guidance of using the developed models and the performance tables of the TERPs was confirmed with respect to the use of TERPs in the construction of heating, ventilation, and air conditioning (HVAC) systems.

Effects of the convergence tolerance of iterative methods used in the boundary element method on the calculation results of sound fields in rooms

We investigated the effects of convergence tolerance of iterative methods used in the boundary element method (BEM) on the accuracy of the calculation results of sound fields in rooms via numerical experiments. In particular, we focused on the relation of the sound absorption and diffuseness in rooms to the convergence of each type of calculation results such as frequency responses, reverberation decay curves, and sound pressure level distributions. The results led to the following conclusions: 1) When all room surfaces are absorbing, the smaller the mean sound absorption coefficient is, the slower the convergence is. 2) When the mean sound absorption coefficients are similar, the more unevenly the sound absorbing surfaces distribute, the slower the convergence is. 3) Even if there is similarity in the unevenness of the sound absorption distribution and complexity of the room shape, the difference in the relative arrangement between the sound absorbing and diffusive surfaces affects the convergence of the results. 4) The reverberation length is not related to the convergence of the calculated reverberation decay curve. 5) The convergence of the calculation results correlates with the mean value of the finite differences of the frequency response. Finally, we recommend convergence tolerance values for each considered type of calculation results. Moreover, we confirmed the results via a numerical analysis of a real room.

Impact of a Quality Improvement Infection Risk Reduction Program on Pathogen Presence in High School and Collegiate Athletic Training Room Facilities

Objectives:Athletic training rooms have a high prevalence of bacteria, including multidrug resistant organisms, increasing the risk for both local and systematic infections in athletes. There is limited data outlining formal protocols or standardized programs to reduce the bacterial and viral burden in training rooms as a means of decreasing infection rate at the collegiate and high school levels. The purpose of this study is to implement established hygiene principles to high school and collegiate athletic training rooms to reduce bacterial and viral burden using a quality improvement infection control program. The authors hypothesize that implementation of such a program will reduce bacterial and viral counts in athletic training rooms over the course of one academic year.Methods:Two high school and two college athletic training rooms were studied over the course of one academic year. A three-phase protocol, including introduction of disinfectant products, implementation of posters and checklists, and student-athlete and athletic trainer education was implemented at the four schools. Multiple surfaces in athletic training rooms were swabbed at four time points throughout the investigation, corresponding with each phase of protocol implementation (Image 1). Bacterial and viral burden from swabs were analyzed for overall bacterial aerobic plate count (APC), influenza viral load and the presence of multidrug resistant organisms such methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin resistant enterococcus (VRE).Results:Overall bacterial load, as measured by APC, was reduced by 94.7% (95% CI [72.6, 99.0], p = 0.003) over the course of the investigation following protocol implementation. Image 2 demonstrates the downward trend in bacterial load averaged across all surfaces sampled over the course of the study. MRSA and VRE were found on 24% of surfaces prior to intervention and were reduced to 0% by the end of the study. Influenza was initially detected on 25% of surfaces with no detection following intervention. No cases of athletic training room acquired infections were reported during the study period.Conclusion:A uniform infection control protocol implemented in the athletic training room of four secondary schools was effective in reducing bacterial and viral burden, including multidrug resistant organisms, over the course of one academic year. Future investigations will focus on expanding this protocol to a larger number of schools with broader demographics.

Reduction of hazardous chemicals in Swedish preschool dust through article substitution actions

Consumer goods and building materials present in the preschool environment can be important sources of hazardous chemicals, such as plasticizers, bisphenols, organophosphorus and brominated flame retardants, poly- and perfluoroalkyl substances, which may pose a health risk to children. Even though exposure occurs via many different pathways, such as food intake, inhalation, dermal exposure, mouthing of toys etc., dust has been identified as a valuable indicator for indoor exposure. In the present study, we evaluate the efficiency of product substitution actions taken in 20 Swedish preschools from the Stockholm area to reduce the presence of hazardous substances in indoor environments. Dust samples were collected from elevated surfaces in rooms where children have their everyday activities, and the concentrations found were compared to the levels from a previous study conducted in 2015 at the same preschools. It was possible to lower levels of hazardous substances in dust, but their continued presence in the everyday environment of children was confirmed since bisphenol A, restricted phthalates and organophosphate esters were still detectable in all preschools. Also, an increase in the levels of some of the substitutes for the nowadays restricted substances was noted; some of the alternative plasticizers to phthalates, such as DEHA and DEHT, were found with increased concentrations. DINP was the dominant plasticizer in preschool dust with a median concentration of 389 μg/g, while its level was significantly (p = 0.012) higher at 716 μg/g in preschools with polyvinyl chloride (PVC) flooring. PBDEs were now less frequently detected in dust and their levels decreased 20% to 30%. This was one of the few times that PFAS were analyzed in preschool dust, where 6:2 diPAP was found to be most abundant with a median concentration of 1140 ng/g, followed by 6:2 PAP 151 ng/g, 8:2 diPAP 36 ng/g, N-Et-FOSAA 18 ng/g, PFOS 12 ng/g, PFOA 7.7 ng/g and PFNA 1.1 ng/g. In addition, fluorotelomer alcohols were detected in 65–90% of the samples. Children's exposure via dust ingestion was evaluated using intermediate and high daily intake rates of the targeted chemicals and established health limit values. In each case, the hazard quotients (HQs) were < 1, and the risk for children to have adverse health effects from the hazardous chemicals analyzed in this study via dust ingestion was even lower after the product substitution actions were taken in preschools.

Making the switch from task illumination to ambient illumination standards: Principles and practicalities, including energy implications

It has been proposed that general lighting practice should switch from specifying indoor illumination standards in terms of task illuminance to ambient illumination specified in terms of mean room surface exitance. The reasons for this proposal are reexamined and the energy implications are assessed. To enable comparison of equivalent levels of illumination, it was first necessary to establish mean room surface exitance levels that equate to task illuminance levels as being typical for similar applications. A simulation was developed using AGi32 lighting design software to determine lighting power density levels for providing equivalent illumination by three luminaire luminous flux distributions for three room shapes with three surface reflectance combinations. As anticipated, the downlight distribution was found to be the most efficient way of satisfying task illuminance criteria, but also it was found that uplighting achieves similar lighting power density levels for the equivalent mean room surface exitance criteria if room surface reflectances are reasonably high, indicating that the switch could be made without departing from the lighting power density limiting values currently proposed for efficient use of lighting energy. However, to base lighting standards on low lighting power density levels would have the effect of severely restricting options in lighting practice. Accordingly, a range of lighting power density levels is proposed for lighting standards that would eliminate inefficient use of lighting energy while permitting reasonable levels of design flexibility in lighting practice.

Understanding ultraviolet light surface decontamination in hospital rooms: A primer

Ongoing challenges in maintaining optimum manual cleaning and disinfection of hospital rooms have created increased interest in "no-touch" decontamination technologies including the use of ultraviolet light (UV). Trials have shown that some UV devices can decrease surface contamination and reduce healthcare-associated infections. Despite substantial marketing of these devices for use in healthcare settings, few data are available regarding the doses of UV-C necessary to yield desired reductions in healthcare pathogens and the ability of mobile devices to deliver adequate doses to various surfaces in patient rooms. This review summarizes the physical aspects of UV that affect the doses delivered to surfaces, the UV-C doses needed to yield 3 log10 reductions of several important healthcare-associated pathogens, the doses of UV-C that can be achieved in various locations in patient rooms using mobile UV-C devices, and methods for measuring UV doses delivered to surfaces.

Impact of Silver Ion Laundry Treatment on Athletic Gear and Environmental Pathogens and Athlete Health

Community-acquired infections caused by Staphylococcus and MRSA can spread easily through sharing towels, gear and contaminated surfaces. The resulting skin infections can lead to athlete disqualifications, cancellations of competitions and potential impact on team performance. In this study, we evaluate a residual antimicrobial textile treatment as an environmental hygiene and infection control strategy through improved textile cleanliness and reduced athlete risk for infection. PURPOSE: To determine the impact of silver-based residual antimicrobial textile treatment on Staphylococcus and MRSA levels on athletic gear, environmental surfaces, athlete infection rates and number of missed play days. METHODS: The study, conducted at a professional sports facility over a six-month period, included pre-season and regular season use. Residual antimicrobial silver ion laundry additive was injected onto textiles during the final rinse stage of the facility’s standard laundry process. Bioburden data for Staphylococcus and MRSA was collected approximately every 4 weeks using contact plates. Athletes’ shirts, shorts, jerseys, girdles and towels, and locker room surfaces including carpets, upholstery and other hard surfaces were sampled. Infection rates and number of days missed pre- and post-laundry treatment are also being recorded. Samples collected before initiating the silver ion textile treatment served as the control data set. RESULTS: Prior to silver-ion treatment implementation, significant levels of Staphylococcus were measured on athlete textiles (average 75 CFU/100 sq. cm.) and on environmental surfaces (average 16 CFU/100 sq. cm.). Silver ion treatment of the textiles resulted in dramatic decreases in Staphylococcus by 77% on textiles and by 37.5 % on environmental surfaces. Similar trends were also observed with MRSA. The overall bioburden levels continue to trend downward during the period of treatment. CONCLUSIONS: The current results demonstrate that a normal laundry process augmented with an active antimicrobial treatment provide athletic gear and a locker room environment that are and stay cleaner. Final data related to cleanliness, infection rates and player days will be tallied at the close of 2018.

Impact of Silver Ion Laundry Treatment on Athletic Gear and Environmental Pathogens and Athlete Health

Community-acquired infections caused by Staphylococcus and MRSA can spread easily through sharing towels, gear and contaminated surfaces. The resulting skin infections can lead to athlete disqualifications, cancellations of competitions and potential impact on team performance. In this study, we evaluate a residual antimicrobial textile treatment as an environmental hygiene and infection control strategy through improved textile cleanliness and reduced athlete risk for infection. PURPOSE: To determine the impact of silver-based residual antimicrobial textile treatment on Staphylococcus and MRSA levels on athletic gear, environmental surfaces, athlete infection rates and number of missed play days. METHODS: The study, conducted at a professional sports facility over a six-month period, included pre-season and regular season use. Residual antimicrobial silver ion laundry additive was injected onto textiles during the final rinse stage of the facility’s standard laundry process. Bioburden data for Staphylococcus and MRSA was collected approximately every 4 weeks using contact plates. Athletes’ shirts, shorts, jerseys, girdles and towels, and locker room surfaces including carpets, upholstery and other hard surfaces were sampled. Infection rates and number of days missed pre- and post-laundry treatment are also being recorded. Samples collected before initiating the silver ion textile treatment served as the control data set. RESULTS: Prior to silver-ion treatment implementation, significant levels of Staphylococcus were measured on athlete textiles (average 75 CFU/100 sq. cm.) and on environmental surfaces (average 16 CFU/100 sq. cm.). Silver ion treatment of the textiles resulted in dramatic decreases in Staphylococcus by 77% on textiles and by 37.5 % on environmental surfaces. Similar trends were also observed with MRSA. The overall bioburden levels continue to trend downward during the period of treatment. CONCLUSIONS: The current results demonstrate that a normal laundry process augmented with an active antimicrobial treatment provide athletic gear and a locker room environment that are and stay cleaner. Final data related to cleanliness, infection rates and player days will be tallied at the close of 2018.

Improving Environmental Disinfection through Objective Assessments at a Large Teaching Hospital

BACKGROUND: Healthcare-associated infections (HAIs) are costly and impact patient morbidity and mortality. Environmental disinfection and cleaning plays a key role in the prevention of HAIs. We aimed to establish an objective evaluation of thoroughness of disinfection and cleaning (TDC) after patient discharge and to evaluate the impact of an assessment program on high-touch surfaces TDC. METHODS: In April 2018, we assessed baseline TDC of environmental surfaces. Fluorescent markers were used for monitoring high-touch surfaces in patient rooms after discharge. TDC scores were defined as the percentage of cleaned surfaces out of the total of examined surfaces. Subsequently, we established routine educational sessions with environmental services staff and developed visual guides where we emphasized the importance of disinfecting high-touch surfaces. A team of two people, one Infection Preventionist and one Environmental Services manager, evaluated TDC on randomly selected units. Direct feedback was provided to staff in rooms with missed opportunities. RESULTS: At baseline, we assessed 401 high-touch surfaces and the TDC score was 51%. After the implementation of the educational sessions, visual guides, and the assessment program, TDC scores increased to 87% (216/247 surfaces), 92% (245/267 surfaces), and 94% (193/205 surfaces) in the following three months. CONCLUSIONS: We improved cleaning of high-touch surfaces by implementing routine educational sessions paired with an objective assessment program. Prospective standardized assessment of cleaning is a key component of infection prevention in health care settings.

Examinations on PEEK wear debris accumulation over counter surfaces in room and vacuum sliding environments

Abstract Wear debris on sliding tracks can often be a significant contributing factor to the friction and wear behaviors of polymer–metal sliding systems. This paper disseminates insightful examinations on the variegated patterns of PEEK wear debris and their mobility/stability on the sliding tracks on counter surfaces of 316L steel discs. Sliding experiments were performed both in an air-conditioned room and in a moderate to high vacuum (25-10 mPa) environments. Counter surface discs were produced by four commercial machining processes: polishing, turning, milling, and grit-blasting. Thereby, different types of counter surface topography were obtained. Light optical microscopic images on wear tracks were recorded to visualize and inspect PEEK wear debris pattern. The polished surface produced discrete and short debris fragments; whereas, grit-blasted counter surface generated thick and continuous debris patches. An attempt was made to explain such dramatically different patterns of debris accumulation as influenced by disc counter surface micro-geometry. Under vacuum sliding conditions, the polished surface produced significant reduction in friction and wear of PEEK, while the grit-blasted surface showed quite opposite response. Turned and milled surfaces exhibited medial behaviors. In addition, milled and grit-blasted surfaces produced discolored debris of PEEK under vacuum condition. Physicochemical changes of PEEK debris under vacuum conditions thus speculated as being the reason behind this observation. Overall, PEEK transfer layer deposition pattern, their quality, and their impact on system's tribological functionalities were found to be strongly influenced by the counter surface topographical characteristics and the sliding environments.

Multidrug-resistant Organisms in Hospitals: What Is on Patient Hands and in Their Rooms?

BackgroundThe impact of healthcare personnel hand contamination in multidrug-resistant organism (MDRO) transmission is important and well studied; however, the role of patient hand contamination needs to be characterized further.MethodsPatients from 2 hospitals in southeast Michigan were recruited within 24 hours of arrival to their room and followed prospectively using microbial surveillance of nares, dominant hand, and 6 high-touch environmental surfaces. Sampling was performed on admission, days 3 and 7, and weekly until discharge. Paired samples of methicillin-resistant Staphylococcus aureus (MRSA) isolated from the patients’ hand and room surfaces were evaluated for relatedness using pulsed-field gel electrophoresis and staphylococcal cassette chromosome mec, and Panton-Valentine leukocidin typing.ResultsA total of 399 patients (mean age, 60.8 years; 49% male) were enrolled and followed for 710 visits. Fourteen percent (n = 56/399) of patients were colonized with an MDRO at baseline; 10% (40/399) had an MDRO on their hands. Twenty-nine percent of rooms harbored an MDRO. Six percent (14/225 patients with at least 2 visits) newly acquired an MDRO on their hands during their stay. New MDRO acquisition in patients occurred at a rate of 24.6/1000 patient-days, and in rooms at a rate of 58.6/1000 patient-days. Typing demonstrated a high correlation between MRSA on patient hands and room surfaces.ConclusionsOur data suggest that patient hand contamination with MDROs is common and correlates with contamination on high-touch room surfaces. Patient hand hygiene protocols should be considered to reduce transmission of pathogens and healthcare-associated infections.